An unusual calf lesion in an immunocompromised patient

  • Maddalena Gili
  • Flavia Chiacchiarini
  • Stefania Morra di Cella
  • Elisabetta Baglioni
  • Maria Felice Brizzi
  • Francesco Giuseppe De Rosa
  • Massimo Porta

Prof. Porta

Dear colleagues, we present today a rare infection developed in an immunocompromised patient, which represented a diagnostic challenge while admitted to our internal medicine ward. Dr. Gili, will you please describe the patient?

Case presentation

Dr. Gili

A 71-year-old man affected by chronic lymphatic leukemia arrived in the emergency department with a swollen and tender right calf. The patient reported a 7-kg weight loss over the previous month and his current therapy included antiviral (acyclovir 400 mg bid) and trimethoprim–sulfamethoxazole (160 mg twice weekly) prophylaxis, prednisone 25 mg od, and a proton pump inhibitor.

Clinical examination showed normal vital parameters except for mild fever and confirmed swelling, approximately 8 cm in length, of the postero-medial region of right calf. Laboratory findings revealed mild anemia, elevated C-reactive protein levels and procalcitonin within the normal range. A previously known lesion of the left lung appeared enlarged...


Compliance with ethical standards

Conflict of interest

The Authors declare that they have no conflict of interest.

Statement of human and animal rights

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patient before applying the diagnostic and therapeutic procedures described.


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Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Department of Medical SciencesUniversity of TurinTurinItaly
  2. 2.Department of General and Specialized SurgeryCittà della Salute e della Scienza di TorinoTurinItaly

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